Discordance of biomarker status in recurrent breast cancer

Objective: To study the pattern of percentage change of biomarker status in recurrent breast cancer and to compare it with its primary biomarker. Methods: Patients with recurrent breast disease presenting to the Breast Unit of Liaquat National Hospital and Medical College, Karachi, between January 2004 and January 2011 were included in this study. Outcome of interest was any change in the biomarker status of oestrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 (HER2/neu) with respect to their respective primary status. SPSS 18 was used for statistical analysis. Results: The study had a total of 58 female patients with biopsy-proven recurrent breast carcinoma with a mean age of 46±11.3 years. Time to recurrence varied between 2 to 3 years with a mean of 2.3±1.9 years. Invasive ductal carcinoma was the most prevalent recurrent tumour (50/58 patients: 86%). There was a change of 25.9% in oestrogen receptor status (p 0.01); change of 36.2% in progesterone receptor status (p=0.036); and 22.4% change in Her2/neu status (p= 0.01). Of the 42 (72.27%) patients who were triple negative at presentation, 30 (71.4%) remained triple negative ( p=0 .02). Six of the 16 (37.5%) patients became triple negative upon recurrence (p 0.01). Conclusions: The study demonstrated that there was indeed a change in biomarker status in patients presenting with recurrent breast carcinoma. There is need for clinicians to check biomarker status in recurrent breast cancer patients as it may assist a shift in the management plan